Continuous retrograde cerebral perfusion aids repair of aortic laceration during sternal re-entry

We successfully repaired an anticipated large laceration of the ascending aorta occurring during sternal re-entry in a 68-year old woman undergoing replacement of a prosthetic aortic valve. Cerebral protection was ensured by using continuous retrograde cerebral perfusion via femoro-femoral bypass with deep hypothermia. The cooling time was 20 minutes. The minimum nasopharyngeal temperature was 15 degrees C and the duration of the retrograde perfusion was 11 minutes at a rate of 600 ml per minute. The postoperative course was uneventful and no neurological deficits occurred.